Rakocevic Stojanovic Vidosava, Peric Stojan, Paunic Teodora, Pesovic Jovan, Vujnic Milorad, Peric Marina, Nikolic Ana, Lavrnic Dragana, Savic Pavicevic Dusanka
Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia.
Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia.
J Neurol Sci. 2016 Jun 15;365:158-61. doi: 10.1016/j.jns.2016.04.018. Epub 2016 Apr 16.
To analyze quality of life (QoL) in a large cohort of myotonic dystrophy type 2 (DM2) patients in comparison to DM1 control group using both generic and disease specific questionnaires. In addition, we intended to identify different factors that might affect QoL of DM2 subjects.
49 DM2 patients were compared with 42 adult-onset DM1 patients. Patients completed SF-36 questionnaire and individualized neuromuscular quality of life questionnaire (INQoL). Following measures were also included: Medical Research Council 0-5 point scale for muscle strength, Addenbrooke's cognitive examination revised for cognitive status, Hamilton rating scale for depression, Krupp's fatigue severity scale and daytime sleepiness scale (DSS) RESULTS: SF-36 total score and physical composite score did not differ between DM1 and DM2 patients (p>0.05). However, role emotional and mental composite score were better in DM2 (p<0.05). INQoL total score was similar in both groups (p>0.05), although DM2 patients showed less impairment in independence (p<0.05) and body image domains (p<0.01). Regarding symptoms assessed by INQoL, DM2 patients showed less severe complaint of myotonia (p<0.01). Multiple linear regression analysis showed that significant predictors of worse QoL in DM2 patients were older age, worse muscle strength and higher level of fatigue.
QoL reports of DM2 patients with the most severe form of the disease are comparable to those of DM1 patients. Special attention of clinicians should be paid to DM2 patients with older age, more severe muscle weakness and higher level of fatigue since they may be at higher risk to have worse QoL.
使用通用问卷和疾病特异性问卷,分析一大群2型强直性肌营养不良(DM2)患者与DM1对照组相比的生活质量(QoL)。此外,我们旨在确定可能影响DM2患者生活质量的不同因素。
49例DM2患者与42例成年发病的DM1患者进行比较。患者完成了SF-36问卷和个性化的神经肌肉生活质量问卷(INQoL)。还包括以下测量:医学研究委员会0-5分肌肉力量量表、修订后的用于认知状态的Addenbrooke认知检查、汉密尔顿抑郁评定量表、Krupp疲劳严重程度量表和日间嗜睡量表(DSS)。结果:DM1和DM2患者的SF-36总分和身体综合评分无差异(p>0.05)。然而,DM2患者的角色情感和心理综合评分更好(p<0.05)。两组的INQoL总分相似(p>0.05),尽管DM2患者在独立性(p<0.05)和身体形象领域(p<0.01)的损害较小。关于INQoL评估的症状,DM2患者的肌强直主诉较轻(p<0.01)。多元线性回归分析表明,DM2患者生活质量较差的显著预测因素是年龄较大、肌肉力量较差和疲劳程度较高。
患有最严重形式疾病的DM2患者的生活质量报告与DM1患者相当。临床医生应特别关注年龄较大、肌肉无力更严重和疲劳程度较高的DM2患者,因为他们可能有更差生活质量的更高风险。